title: Domestic global health: a curriculum teaching medical students to evaluate refugee asylum seekers and torture survivors.
abstract: BACKGROUND
  Seven to 12% of foreign-born patients in the United States has experienced torture. We aimed to teach medical students to identify and care for asylum seekers/torture survivors.
  
  
  METHODS
  One hundred twenty-five students participated in a program consisting of a workshop covering sequelae of torture, asylum law, and an approach to patient evaluation; twice-monthly clinical sessions; and mentored preparation of medical affidavits. We observed clinical encounters; evaluated medical affidavits; and assessed students' knowledge, attitudes, and skills pre- and postcurriculum.
  
  
  RESULTS
  Students successfully performed physical and psychological evaluations and prepared affidavits resulting in 89% asylum application approval. We observed improvement in student attitudes toward working with survivors (p < .05), knowledge of sequelae of torture (p < .001), and self-efficacy in clinical evaluation (p < .001).
  
  
  CONCLUSIONS
  Medical students learned necessary skills to provide services for survivors, which will also serve them in caring for other vulnerable populations. As an advocacy, cultural competency, and domestic global health opportunity, this training was feasible and achieved its educational goals.
authors.affiliation: a Icahn School of Medicine at Mount Sinai , New York , New York , USA.
authors.forename: Ramin
authors.initials: R
authors.lastname: Asgary
authors.forename: Pamela
authors.initials: P
authors.lastname: Saenger
authors.forename: Loretta
authors.initials: L
authors.lastname: Jophlin
authors.forename: Delia C
authors.initials: DC
authors.lastname: Burnett
mesh_terms: D000328:Adult; D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D005260:Female; D014943:Global Health; D006801:Humans; D008297:Male; D010808:Physical Examination; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis; D013337:Students, Medical; D017741:Survivors / Q000523:psychology*; D014104:Torture; D014481:United States